According to the technical note on unconditional probability of dying from exact ages of 30 to 70 years from any of the mayor four NCDs [1], this form of indicator excludes confounding across countries or over time due to differences or changes in mortality rates for other competing causes and to control for differences in population age structure.
I’m looking for the rationale or technical foundations behind the statement that this indicator controls for differences or changes in population age structure, meaning that it is a comparable measure across countries or over time without age adjustment or standardization.
Thanks
Reference:
[1] World Health Organization (2012). Mortality form NCDs. Technical Note April 26, 2012. Available online: http://www.who.int/nmh/events/2012/note_20120426.pdf
Like many other measures, It's a statistical formula, complex, so you'd have to be a true expert in that area to undertstand it as a "rationale."
I would argue that unconditional probabilities of chronic disease mortality as a basis of comparison across nations would be very questionable. There may be somewhat of a confidence for such comparative analysis if the SES and other major parameters of the comparison units were reasonably similar, but that would be far from true if you compare developing nations, Asian, African, South American, or Oceania against Europe or North America. Reporting, diagnostic criteria, accuracy of death certificates, processing and preservation of mortality data are all highly problematic in many places and there is a very significant error/omission rate even in the most industrialized nations.
Most health care providers will agree, if asked, that they offer services in a blind environment because regarding chronic conditions we have scant endemic data, very poor morbidity data, and spotty mortality data. So we treat "whatever comes through the door" on the assumption that this traffic of patients is in some way representative. With chronic disease that is, in my opinion, highly debatable.
Dear Richard,
Thank you so much for sharing your arguments on this question.
Regards,
Ramon
I have searched extensively for the report and cannot find one based on your citaton. Can you please post a link or provide the exact citation.?
I believe the note you provide serves as a rationale or "technical fooundation "for its use and provides the formula. What about making something linear when it is not , in order to measure the influence of each of several factors? That, too has a formula for a "rationale." What I would wonder is how accurate are the results?
Dear Mary-Helen,
I appreciate your effort to provide an answer to my question.
I'm just referring to the technical note I included in the reference, and the link is also provided (just below the reference it-self)
The concept of probability of dying could be found in any technical document about methods of life tables.
I'm just looking for a the technical arguments that support the statement -from the technical note- that "the probability of dying controls for differences in age-structure of the population"
Thanks
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